Disseminated Fusarium infection presenting as bilateral endogenous endophthalmitis in a patient with acute myeloid leukemia.

onstrated no signs of infection and laboratory studies did not reveal a source of infection. Scattered cerebral infarction from arterial air emboli was unlikely because no evidence of ischemia was detected on a diffusion-weighted MRI. The timing of cortical blindness in our patient, shortly after inadvertent arterial entry during attempted PICC line placement, and the focal leptomeningeal enhancement on MRI suggest that breakdown of the bloodbrain barrier was iatrogenic. The precise mechanisms underlying this process remain unclear, but we postulate that transient hyperosmolarity and hypertension may have been involved in the pathogenesis of our patient’s symptoms.

[1]  S. Rapoport Osmotic Opening of the Blood–Brain Barrier: Principles, Mechanism, and Therapeutic Applications , 2000, Cellular and Molecular Neurobiology.

[2]  R. Fanin,et al.  Endogenous endophthalmitis following disseminated fungemia due to Fusarium solani in a patient with acute myeloid leukemia , 2002, European journal of haematology.

[3]  S. Katz,et al.  Visual loss and central venous catheterization: cortical blindness and hemianopsia after inadvertent subclavian artery entry. , 2000, Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society.

[4]  R. Alsarraf,et al.  Angiography contrast-induced transient cortical blindness. , 1999, American journal of otolaryngology.

[5]  L. Petrus,et al.  Iatrogenically induced cortical blindness associated with leptomeningeal enhancement. , 1998, AJNR. American journal of neuroradiology.

[6]  C. Meltzer,et al.  MR imaging of the meninges. Part I. Normal anatomic features and nonneoplastic disease. , 1996, Radiology.

[7]  B. Glasgow,et al.  Bilateral endogenous Fusarium endophthalmitis associated with acquired immunodeficiency syndrome. , 1996, Archives of ophthalmology.

[8]  R. Hutchins,et al.  Fusarium endophthalmitis in an intravenous drug abuser. , 1996, American journal of ophthalmology.

[9]  F. El Baba,et al.  Endogenous endophthalmitis due to Fusarium: case report and review. , 1994, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[10]  M. Elman,et al.  Endogenous Fusarium endophthalmitis in a patient with acute lymphocytic leukemia. , 1994, American journal of ophthalmology.

[11]  J. Rees,et al.  Transient cortical blindness after coronary angiography. , 1993, British heart journal.

[12]  M. Mikus,et al.  Transient cortical blindness due to hypertensive encephalopathy. Magnetic resonance imaging correlation. , 1993, Journal of clinical neuro-ophthalmology.

[13]  M. Socinski,et al.  Successful treatment of disseminated Fusarium infection after autologous bone marrow transplantation for acute myeloid leukemia. , 1991, Bone marrow transplantation.

[14]  P. Shyn,et al.  Transient cortical blindness following cerebral angiography. , 1989, The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society.

[15]  G. Lantos Cortical blindness due to osmotic disruption of the blood‐brain barrier by angiographic contrast material , 1989, Neurology.

[16]  W. Marshall,et al.  Neurotoxicity of radiological contrast agents , 1983, Annals of neurology.

[17]  E. Bottone,et al.  Fusarium solani endophthalmitis without primary corneal involvement. , 1979, American journal of ophthalmology.

[18]  C T Cho,et al.  Fusarium solani infection during treatment for acute leukemia. , 1973, The Journal of pediatrics.